Shen Bo, Xu Jiarui, Wang Yimei, Jiang Wuhua, Zhang Zhen, Yu Jiawei, Zou Jianzhou, Teng Jie, Ding Xiaoqiang
Contrib Nephrol. 2018;193:68-80. doi: 10.1159/000484964. Epub 2018 Jan 23.
Acute kidney injury (AKI) is common in clinical practice and associated with increased risk for death and major morbidity. Although some meaningful clinical guidelines were published, the quality of AKI healthcare remains suboptimal. Some AKI quality improvement methods, such as guidelines-based training programs, the referral from nephrology, and electronic data system have been found to be potentially beneficial, but further validation is required. Quality measures (QMs) for structure, process, and outcome of AKI care need to be further developed, evaluated, and implemented to ensure utmost quality of AKI care. However, many unknowns remain in this field. Some commonly used QMs like mortality are still difficult to realize in AKI quality control because of the heterogeneity in AKI practice. More evidence is needed to improve the AKI quality control system. These are challenges that will need to be addressed in the future.
急性肾损伤（AKI）在临床实践中很常见，且与死亡风险增加和严重发病相关。尽管已发布了一些有意义的临床指南，但AKI医疗保健质量仍不尽人意。一些AKI质量改进方法，如基于指南的培训项目、肾内科转诊和电子数据系统，已被发现可能有益，但仍需进一步验证。AKI护理结构、过程和结果的质量指标（QMs）需要进一步制定、评估和实施，以确保AKI护理的最高质量。然而，该领域仍存在许多未知因素。由于AKI实践的异质性，一些常用的质量指标，如死亡率，在AKI质量控制中仍难以实现。需要更多证据来完善AKI质量控制系统。这些都是未来需要解决的挑战。
